Gestational Diabetes Mellitus

Stacey M. Thacker, PharmD, BCPS; Katherine A. Petkewicz, PharmD

Disclosures

US Pharmacist. 2009;34(9):43-48. 

In This Article

Abstract and Introduction

Introduction

Gestational diabetes mellitus (GDM) is a common medical complication associated with pregnancy. GDM is defined as any degree of glucose intolerance that occurs with pregnancy or is first discovered during pregnancy.[1] GDM imposes risks on both mother and fetus. Some of these risks continue throughout the lifetime of mother and child. Maternal complications include pre-eclampsia, hyperglycemic crisis, urinary tract infections that may result in pyelonephritis, need for cesarean sections, morbidity from operative delivery, increased risk of developing overt diabetes, and possibly cardiovascular complications later in life, including hyperlipidemia and hypertension. Mothers with GDM have a 50% chance of developing type 2 diabetes mellitus (T2DM) for the 20 years following their diagnosis of GDM. Maternal hyperglycemia causes increased glucose delivery to the fetus, resulting in fetal hyperinsulinemia and increased fetal growth. Complications of excessive fetal growth include birth trauma, increased cesarean deliveries, and the long-term risk of glucose intolerance and obesity. Other immediate fetal complications include hypoglycemia, hyperbilirubinemia, respiratory distress syndrome, cardiomyopathy, and hypocalcemia.[2–5] This plethora of risks demonstrates the importance of early risk stratification with appropriate screening and diagnosis and of therapeutic interventions that maintain optimal glycemic control.

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